Many people do not realize that lack of sufficient sleep can trigger mild to potentially life–threatening consequences, from weight gain to a heart attack. Recently I came across an article in the Harvard Health Newsletter (Health Beat) and thought of sharing the information with you all.

Viral infections: Anecdotal evidence supports the belief that when you’re tired and run–down, you’re more likely to get sick. A 2009 study in Archives of Internal Medicine provides some proof. Researchers followed the sleep habits of 153 men and women for two weeks, then quarantined them for five days and exposed them to cold viruses. People who slept an average of less than seven hours per night were three times as likely to get sick as those who averaged at least eight hours.

Weight gain: Not getting enough sleep makes you more likely to gain weight, according to a 2008 review article in the journal Obesity that analyzed observations from 36 different studies of sleep duration and body weight. This association is especially strong among children. Lack of sufficient sleep tends to disrupt hormones that control hunger and appetite, and the resulting daytime fatigue often discourages you from exercising. Excess weight, in turn, increases the risk of a number of health problems.

Diabetes: A 2009 report in Diabetes Care found a sharp increase in the risk of type 2 diabetes in people with persistent insomnia. People who had insomnia for a year or longer and who slept less than five hours per night had a three–fold higher risk of type 2 diabetes compared with those who had no sleep complaints and who slept six or more hours every night. As with overweight and obesity (which are also closely linked to type 2 diabetes), the underlying cause is thought to involve a disruption of the normal hormonal regulation of the body due to inadequate sleep.

High blood pressure: Researchers involved in the diabetes study also evaluated risk of high blood pressure among the same group of people, which included more than 1,700 randomly chosen men and women from rural Pennsylvania. As described in a 2009 article in the journal Sleep, the researchers found the risk of high blood pressure was three–and–a–half times greater among insomniacs who routinely slept less than six hours per night compared with normal sleepers who slept six or more hours nightly.

Heart disease: A number of studies have linked short–term sleep deprivation with several well–known risk factors for heart disease, including higher cholesterol levels, higher triglyceride levels, and higher blood pressure. One such report, published in a 2009 issue of Sleep, included more than 98,000 Japanese men and women ages 40 to 79 who were followed for just over 14 years. Compared with women who snoozed for seven hours, women who got no more than four hours of shut–eye were twice as likely to die from heart disease, the researchers found.

Sleep apnea is a common cause of poor sleep, a life–threatening condition in which breathing stops or becomes shallower hundreds of times each night also increases heart disease risk. In the Wisconsin Sleep Cohort study, people with severe sleep apnea were three times more likely to die of heart disease during 18 years of follow–up than those without apnea. When researchers excluded those who used a breathing machine (a common apnea treatment), the risk jumped to more than five times higher. Apnea spells can trigger arrhythmias (irregular heartbeats), and the condition also increases the risk of stroke and heart failure.

Mental illness: A study of about 1,000 adults ages 21 to 30 found that, compared with normal sleepers, those who reported a history of insomnia during an interview were four times as likely to develop major depression by the time of a second interview three years later. Two studies in young people–one involving 300 pairs of young twins, and another including about 1,000 teenagers–found that sleep problems developed before a diagnosis of major depression and (to a lesser extent) anxiety. Sleep problems in teenagers preceded depression 69% of the time and anxiety disorders 27% of the time.

Mortality: In the Japanese heart disease study (described above), short sleepers of both genders had a 1.3–fold increase in mortality compared with those who got sufficient sleep. According to a 2009 study of 6,400 men and women whom researchers followed for an average of eight years, severe sleep apnea raises the risk of dying early by 46%. Although only about 8% of the men in the study had severe apnea, those who did and who were between 40 and 70 years of age were twice as likely to die from any cause as healthy men in the same age group.

It is clear that getting enough sleep is just as important as other vital elements of good health, such as eating a healthy diet, getting regular exercise, and practicing good dental hygiene.

In short, sleep is not a luxury but a basic component of a healthy lifestyle.

Inaugurating a two days workshop on Stress Management and how to be happy and healthy Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal

National News

138m Indian smokers unaware that puff causes stroke

NEW DELHI: Of the 275 millions Indians who consume tobacco, nearly 138 million do not know that smoking causes stroke. As many as 92 million aren’t aware that tobacco causes heart disease. According to a report released by the World Heart Federation (WHF) on Friday, half of all Chinese smokers and one–third of Indian smokers are unaware of the risks tobacco pose to our heart. Awareness of the risk of secondhand smoke is even lower. According to WHF, cardiovascular disease (CVD) is the world’s leading cause of death, killing 17.3 million people every year. Around 80% of these deaths occur in low and middle–income countries like India, which are increasingly being targeted by the tobacco industry. Tobacco use and secondhand smoke exposure causes about 1/10th of global deaths from CVD. Secondhand smoke exposure increases the risk of heart disease by 25% and more than 87% of worldwide adult deaths caused by secondhand smoke are due to CVD. The report – Cardiovascular Harms from Tobacco Use and Secondhand Smoke – was commissioned by the WHF and written by the International Tobacco Control Project (ITC Project) in collaboration with the Tobacco Free Initiative at the World Health Organization (WHO). (Source: TOI, Apr 21, 2012)

In a "position paper" on the new oral anticoagulants, a group of experts from the European Society of Cardiology Working Group on Thrombosis are enthusiastic about the new agents in AF, but not so impressed with their use in ACS. While the authors welcome all three new drugs as attractive alternatives to warfarin, they come down in favor of apixaban as having the best data in AF. On which patients should receive the new drugs, the position paper notes that patients already on long–term warfarin with well–controlled INRs and handling the monitoring without problems derive "uncertain overall advantages" from switching to the new oral anticoagulants, "and the arguments for changing treatment in such patients appear weaker than for other patient categories. (Source: Medscape)

Healthy gums aren’t proven to prevent heart disease, nor will treating periodontal disease clearly reduce risk of heart attack or stroke, according to a scientific statement from the American Heart Association (AHA). The two conditions are linked through common risk factors without convincing evidence for a causal relationship, the statement cautioned in the May 22 issue of Circulation: Journal of the American Heart Association. (Source: Medpage Today)

Immediate psychiatric therapy for trauma patients in the emergency department (ED) may decrease the emergence of posttraumatic stress disorder (PTSD) and appears to be most effective in sexual assault victims, new research shows. Presented here at the Anxiety Disorders Association of America (ADAA) 32nd Annual Conference, a study by investigators from Emory University in Atlanta, Georgia, showed that trauma patients who received emergency psychiatric treatment had fewer PTSD symptoms at 3 months than their counterparts who received a basic assessment. (Source: Medscape)

@DrKKAggarwal: Remember the health windows The window for the deadliest form of heart attack, called ST–elevation myocardial

@DrKKAggarwal: The key to success, well being, happy relationships and higher consciousness is self awareness

Spiritual Update

(Dr KK Aggarwal, Group Editor in Chief, IJCP Group of Publications and eMedinews)

Pranayama – The Breath Control Exercise

Health is not only the absence of disease, it is a state of physical, mental, social, spiritual, environmental and financial well–being. One of the most important steps towards acquiring comprehensive health is control of the mind and a direct contact with the chitta or consciousness.

Using special instruments, the doctor will slowly widen the opening to your uterus (cervix). Opening your cervix can cause cramping. If this procedure is performed in the doctor’s office, you will receive medications that numb your cervix and make it easier to open. After dilating (opening) the cervix (mouth of the womb), tissue from inside the uterus is removed with a scraping instrument (curette), a suction tube, or other specialized instruments.

In a small baby even left lateral segment may be too large for the small size vessels that the patient has. Therefore, after removing a part of the liver (usually left lateral), a bench surgery i.e. surgery on the table is performed to reduce the weight and size and make it appropriate to the weight and needs of the child.

Alfred Bernhard Nobel (21 October 1833 – 10 December 1896) was a Swedish chemist, engineer, innovator, and armaments manufacturer. He is the inventor of dynamite. Nobel also owned Bofors, which he had redirected from its previous role as primarily an iron and steel producer to a major manufacturer of cannon and other armaments.

Nobel held 355 different patents, dynamite being the most famous. In his last will, he used his enormous fortune to institute the Nobel prize. The synthetic element nobelium was named after him. His name also survives in modern–day companies such as Dynamit Nobel and Akzo Nobel, which are descendents of the companies Nobel himself established.

‘The one personal trait of Nobel that helped him to sharpen his creativity include his talent for information access, via his multilingual skills. Despite the lack of formal secondary and tertiary level education, Nobel gained proficiency in six languages: Swedish, French, Russian, English, German and Italian.

He also developed literary skills to write poetry in English.’ His Nemesis’, a prose tragedy in four acts about Beatrice Cenci, partly inspired by Percy Bysshe Shelley’s The Cenci, was printed while he was dying. The entire stock except for three copies was destroyed immediately after his death, being regarded as scandalous and blasphemous. The first surviving edition (bilingual Swedish–Esperanto) was published in Sweden in 2003. The play has been translated to Slovenian via the Esperanto version and to French. In 2010 it was published in Russia as another bilingual (Russian–Esperanto) edition.

One day, Noble, while looking at the morning newspaper, to his surprise and horror, read his name in the obituary column. The newspapers had reported the death of the wrong person by mistake. His first response was shock. Am I here or there?

When he regained his composure, his second thought was to find out what people had said about him.

The obituary read, "Dynamite King Dies." And also "He was the merchant of death."

When he read the words "merchant of death," he asked himself a question, "Is this how I am going to be remembered?" He got in touch with his feelings and decided that this was not the way he wanted to be remembered. From that day on, he started working toward peace.

Thus the foundations of the Nobel Prize were laid in 1895 when Alfred Nobel wrote his last will, leaving much of his wealth for its establishment. Since 1901, the prize has honored men and women for outstanding achievements in physics, chemistry, medicine, literature and for work in peace.

Situation: A patient with CKD wanted a cardiology reference. Dr Bad: It’s not needed. Dr Good: You should get it done.Lesson: Chronic renal dysfunction alone is an independent risk factor for the development of coronary artery disease, and for more severe coronary heart disease.

Situation: A foreigner with a single loose stool developed sepsis. Reaction: Oh my God! Why were antibiotics not started in time.Lesson: Make sure that all foreigners are diagnosed to be suffering from Travelers diarrhea even if there is one single loose motion.

I am a Professor of Pathology in USA. I want to know how I can obtain post–mortem images from a recent autopsy done in Hyderabad, India. In US courts the postmortem details including photos are available to both to prosecution and defence side, I want to know if this is also the case in India.

Ans.

It seems that you are talking about some medicolegal case in India where autopsy was done and you want to have the data related to that autopsy. You can have it only if you are one of the parties before the court. If a litigant wants your expert opinion on the data, he has to procure the data and make it available to you. You cannot access it directly.

In India, as in USA, the postmortem details including photos are available to both the prosecution and the defence.

The infection prevention and control measures outlined here are to be practiced for respiratory viral infection outbreaks like SARS and HINI (CDC Guidelines 2009 for HINI), etc.

Droplet Precautions/Respiratory Protection: HCP should wear a mask (droplet precautions) or N95 respirator (respiratory protection) when within 2 meters of a case with H1N1. The "95" in N95 refers to the filter efficiency i.e. it can filter 95% of particulate matter measuring 0.3 μm in diameter. The choice between a mask and N95 respirator should be based on the following: A mask should be worn: If within 2 meters of an active patient. An N95 respirator should be worn: If conducting an aerosol–generating medical procedure. HCP should wear all the personal protective equipment (PPE) including eye and face protection (i.e. goggles, safety glasses or face shield).

Cleaning and disinfection of equipment: All the surfaces, frequently touched areas and equipment should be cleaned and disinfected using 1% Sodium hypochlorite, daily in patient’s room/clinic.

Treatment and prophylaxis: The individual HCP taking care of such patients/contacts may take the available prophylaxis with antiviral drugs (e.g. Oseltamivir for H1N1 outbreaks) and or vaccine if available as per the local recommendations.

Y should I get a job? Y should I leave home and find my own place? Y should I get a car when I can borrow yours? Y should I clean my room? Y should I wash and iron my own clothes? Y should I buy any food? Y do I do this? I should I do that?

People who take someone else’s medicine may suffer harm if they take a medicine that is not meant for treating their condition or take the wrong dose. Women who take medicine to try to end a pregnancy are misusing the medicine, and may poison themselves. Poisoning accidents can happen when safety warnings are ignored and chemicals are used in the wrong way. The following are illustrative:

Bleach containers usually contain a warning that bleach should not be mixed with any other cleaner. If people ignore the warning and use bleach with another household cleaner, they may be poisoned by the gases given off.

Insecticides that meant to be used on plants or buildings, if are used to kill insects living on people, in their hair or on their bodies may cause accidental poisoning.

Sometimes people poison themselves by misusing medicines. They may take more than the doctor prescribed because they think, wrongly, that a larger dose will make them better more quickly.

Talking to a gathering of 500 health professional, Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India, said that potbelly obesity is the new epidemic of the society, which is linked to diabetes, high blood pressure and heart blockages. The main culprit is eating carbohydrates in general and in particular refined carbohydrates, everyday. Our Vedic science advocates that one should observe 80 fasts in a year and these should involve not eating cereals. Over a period of time, we have stopped observing fasts and have shifted from carbohydrates to refined carbohydrate–based cereals.

Dr. Aggarwal further said that the ancient Friday’s Santoshi Mata Ka Vrat was meant for child bearing women so that they do not end up with anemia and protein deficiency. The vrat or fast involves eating Gur and Chana in a fasting state. Iron is better observed in fasting state. People have stopped observing Santoshi Mata Ka Vrat and also have stopped eating Gur and chana leading to anemia epidemic in the society.

Dr. Aggarwal further said that Vedic science has been advocating that one month in a year one should sunbathe near the river, which should involve exposing the body before the sun before 10 am or after 4pm. Not observing these principles of nature has lead to epidemic of Vitamin D deficiency in the society.

Dr. Aggarwal was speaking at a workshop on "How to be happy and healthy’ being organized by Heart Care Foundation of India with Bramkumaris at Pataudi Road, Manesar.

BK Sister Asha, Director ORC said that one of the principles of being happy is to observe non–violent communication involving three Cs – Do not condemn! Do not complain! and Do not criticize!

BK Sister Geeta, Director ORC said that if it is not possible to change the situation, one should change his interpretation to that situation.

BK Sister Sapna, Senior Rajyoga said that after the age of 25, one cannot change an adult, one should change oneself.

BK Brij Mohan, Secretary General said that by being happy, it is possible to regress heart blockages.

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions